Individual
CLOVIS TAH FOKUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2024 NICOL CIRCLE, BOWIE, MD 20721
(619) 314-1583
Mailing address
2024 NICOL CIRCLE, BOWIE, MD 20721
(619) 314-1583
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
DC
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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